Arise &Shine

Registration Form Elk Grove Youth Conference

June 19 – 21 2014

Complete this form, have it signed, and then return it with the Permission/Medical Release form, to your Ward YM/YW President by Sunday, May 18, 2014. Each participant (youth or adult) is to submit this form. First Name ____________________________________ Last Name _____________________________________ Ward Gender

Birth date

Age

Address City State Phone Email Parent’s Name Best Phone Medical Insurance Provider Policy #

Parental Liability / Medical Release As I indicated in the attached Parental Permission and Medical Release form, I give permission for my child to participate in the Elk Grove Stake Youth Conference 2014. I am aware that my child will be camping and might encounter outdoor circumstances. I understand there are unforeseeable risks to my child inherent in all outdoor activities, including this Stake-sponsored Youth Conference, which are beyond the control of the Stake staff and Ward leaders. I agree to personally assume such risks. I hold harmless any and all Stake staff and Ward leaders for any and all injury, or expenses resulting from injury sustained, which were not directly caused by negligence on the part of Stake staff or Ward leaders.

Parent’s Signature Date

Youth Conference Pledge

As a participant in Might, Mind, Strength 2014 I pledge to: 1. Know, live and dress the standards found in For The Strength of Youth. 2. Act in such a way as to protect others and myself from danger. Participant 3. Aid and encourage other participants to exercise responsible behavior. 4. Follow “No-Trace” camping guidelines to protect the natural wilderness. 5. Show charitable consideration to all other Leaders and fellow youth. Date

Cell Phone Policy: As convenient as cell phones are, they can be a frustrating and unwelcome distraction to both the user and to the people nearby. Cell phones should not interrupt Youth Conference activities. In order to show courtesy and respect for everyone involved, we ask participants to be good examples and follow these guidelines:

1. Please do not use cell phones for texting, conversation, e–mail, game play, or anything else during organized meetings, devotionals, classes and other activities.

2. If you feel you must have your cell phone with you, please turn it off during activities to avoid the temptation to use it.

3. Camera Features — If your cell phone has a camera, please do not use it when its use could be unwelcome, distracting, or an interruption to others.

The atmosphere at Youth Conference is both spiritual and social. Cell phone use (including texting) typically isolates users and limits their ability to communicate well with those around them. The Elk Grove Stake requires specific leaders to be available through radios and cell phones for purposes of organization and emergencies. We appreciate everyone’s understanding regarding this necessity. Media Use and Consent (check one box): I hereby ☐GRANT ☐ DO NOT GRANT the Elk Grove Stake the absolute right and permission to use my child’s likeness in a photograph, video, broadcast, publish or copyright and use pictures of my child in which he or she may be included in whole or in part, composite or retouched in character or form. I hereby irrevocably authorize the Elk Grove Stake to edit, alter copy, exhibit, publish or distribute photographs and videos of me or my child for informational, educational, promotional, or publicity purposes.

Equipment List

! 1 5-gallon Bucket with name marked with indelible marker (All gear on this list must fit in your bucket, except for sleeping bag & ground pad) ! 1 warm Sleeping Bag ! 1 Blanket ! 1 Coat ! 1 rain Poncho ! 3-4 shirts (No tank tops) ! 3-4 shorts (Knee length or longer) ! 1 pair of Shoes ! 1 pair of Flip flops or sandles ! 1 pair of long pants or sweat pants ! 3 or 4 pairs of sturdy Socks ! 3 sets of Underclothing ! 1 modest swimsuit (Girls – no bare midriffs) ! 1 Water Bottle ! 1 pair of Sunglasses ! 1 Flashlight ! 1 Heavy-duty Garbage Bags ! 1 small personal First Aid Kit (band-aids, cleansing wipes, first aid cream, etc.) ! Personal Items:

! Toothbrush ! Toothpaste ! Deodorant

! Soap ! Washcloth ! Sunscreen

! Lip Balm ! Comb/Brush ! Insect Repellant

! Prescribed Medication ! Towel

! Scriptures ! Your personal Journal (& pen) ! Optional Items

! Ground Pad ! Small Pillow